- CareFirst (Baltimore, MD)
- … Credentialing Specialist (CPCS) **Experience:** 3 years physician credentialing experience or health insurance/ managed care operations experience in a ... legal and company requirements and standards. **ESSENTIAL FUNCTIONS:** + Analyzes credentialing applications to perform the primary source verification of the… more
- US Anesthesia Partners (Dallas, TX)
- …non-merit based factors. (https://careers-usap.icims.com/jobs/15229/facility- credentialing - specialist -ii/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336089587) ... Overview US Anesthesia Partners (USAP) is currently seeking a Credentialing Coordinator to join our team, remotely. Maintains accurate records of providers'… more
- BayCare Health System (Tampa, FL)
- …+ **Days:** Monday through Friday The ** Credentialing and Provider Enrollment Specialist ** is a full-time remote position. This team member must currently ... Managed Care Equal Opportunity Employer Veterans/Disabled **Position** Credentialing and Provider Enrollment Specialist **Location** Tampa:Concourse Center… more
- Spectrum Billing Solutions (Skokie, IL)
- …managed in the most efficient and streamlined manner. We are seeking to add a Credentialing Specialist to our growing team. If you are looking for a rewarding ... our team has the option to work 100% fully remote . Your Responsibilities: + Complete provider credentialing ...communication and problem-solving skills. RCM Analyst | Revenue Cycle Credentialing Specialist | Insurance Specialist … more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …required. Qualifications: + Minimum of two (2) years previous experience in a managed care organization's Credentialing department. + NAMSS CPCS certification is ... Onsite-Not a remote position Maintain an efficient provider credentials system...and processed, correct data entry, and updated regulatory and credentialing documents are entered and/or scanned into the Doctors… more
- Molina Healthcare (MI)
- **_JOB TITLE: Sr. Specialist , Quality Improvement RN (REGISTERED NURSE)_** **_For this position we prefer someone with 5 - 7 years hospital clinical experience and ... prior managed care. It will be very important to have...holidays and weekends may be required._** **_This is a remote based position, work from home._** **JOB DESCRIPTION** **Job… more
- Marshfield Clinic (Marshfield, WI)
- …the most exciting missions in the world!** **Job Title:** Provider Relations Specialist ( Remote Option within SHP Service Area) **Cost Center:** 682891544 ... States of America) **Job Description:** **JOB SUMMARY** The Provider Relations Specialist works in cooperation with the Contracting Manager - Marshfield Clinic… more
- Molina Healthcare (NM)
- …combination of education and experience. **Required Experience** + 3+ years in experience in credentialing in a managed care field + Min. 1 year experience ... **This job is 100% remote . Working hours are in PST M-F 8-5pm.**...oversight assessment/auditing + Data analysis experience **Preferred Credentials** + Credentialing certification **Preferred Education** Bachelor's Degree in Business or… more
- Molina Healthcare (Ann Arbor, MI)
- …requirements of customers as it pertains to contracting, network management and credentialing . **Job Duties** This role negotiates assigned contracts and letters of ... and efficient business results. * Trains and monitors newly hired Contract Specialist (s). * Participates in other contracting related special projects as directed. *… more
- Organon & Co. (Boston, MA)
- **Job Description** **The Position** The Women's Health Clinical Account Specialist (WHCAS) supports customers by providing clinical information on our Company's ... meet the goals of their patients. The Clinical Account Specialist is a key member of our customer-facing team...the needs of customers. + Understanding of the local managed care and reimbursement environment relevant to various customer… more
- CommonSpirit Health (West Jordan, UT)
- …both inside our hospitals and out in the community. **Responsibilities** This is a remote position and strongly prefer someone in Utah or Utah Payer work experience. ... Relationship leadership, to support the negotiation of terms and conditions for Managed Care payer contracts for facility, professional, and ancillary entities. The… more
- Veterans Affairs, Veterans Health Administration (Albany, NY)
- …and procedures. Coordinates and performs documentation maintenance required by the Credentialing & Privileging Manager for the facility. Performs data analysis and ... onboarding, and works with preceptors to ensure the program is properly managed . Handles and resolves patient complaints within the appropriate scope of… more
- WellSense (Boston, MA)
- Contracting Specialist WellSense Health Plan is a nonprofit health insurance company serving members across Massachusetts and New Hampshire through Medicare, ... adherence to best practices. Our Investment in You: + Full-time remote work + Competitive salaries + Excellent benefits **Key Functions/Responsibilities:** .… more
- Molina Healthcare (CA)
- **_ Remote and must live in California _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network ... requirements of customers as it pertains to contracting, network management and credentialing . **Job Duties** This role negotiates assigned contracts and letters of… more
- MD Anderson Cancer Center (Houston, TX)
- …of faculty and staff is completed by gathering appropriate documentation from credentialing and other educational sources, as required by regulatory agencies and ... with Data Management team, Informatics and other SCTCT sections in preparing Managed Care required documentation and submissions. 1.3.3. Works with the Informatics… more
- Molina Healthcare (Ypsilanti, MI)
- …license in the state of MI_ _Quality Improvement RN will work in remote setting supporting Maternity Medicaid population. Connect with Medicaid members to ensure all ... surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist , Quality Improvement (Registered Nurse) contributes to one or… more
- Molina Healthcare (NV)
- **_ Remote and must live in Nevada _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network ... requirements of customers as it pertains to contracting, network management and credentialing . **Job Duties** This role negotiates assigned contracts and letters of… more
- South Middlesex Opportunity Council (Framingham, MA)
- …assignment for specialized programs and grants in collaboration with intake specialist + Participation in the support, ongoing development, and long-term maintenance ... new policies and procedures for the clinics. + Assuming shared responsibility for credentialing of clinic staff and maintenance of local personnel files. + Working… more
- South Middlesex Opportunity Council (Framingham, MA)
- …action with entire management team. + Monitor caseloads and work with the clinic intake specialist to triage and assign cases from a waitlist. + Work with the front ... with federal and state laws and funder requirements. + Credentialing all clinical staff with payors and state agencies...and substance abuse program. + Must have knowledge of managed care practices. + Must be familiar with public… more